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Large laser sheaths for pacing and defibrillator lead removal
Author(s) -
Reiser Christopher,
Taylor Kevin D.,
Lippincott Rebecca A.
Publication year - 1998
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1998)22:1<42::aid-lsm10>3.0.co;2-a
Subject(s) - laser , fluence , materials science , excimer laser , ultraviolet , biomedical engineering , pulse (music) , optics , laser safety , pulse duration , excimer , optoelectronics , medicine , physics , detector
Background and Objective In a recent clinical trial, the 12‐F laser sheath showed 95% success in completely explanting chronically implanted pacing leads smaller than 7.5‐F diameter. For larger leads, two new sizes of laser sheath have been implemented, the 14‐F and 16‐F (outer diameter) devices, which accommodate leads up to 9.5‐ and 11.5‐F, respectively. The object of this study was to determine the cutting ability of the larger devices compared to the 12‐F design. Materials and Methods The rate of device advancement through fresh porcine aorta was measured for three sizes of laser sheath as pulsed ultraviolet light from a 308‐nm XeCl excimer laser was applied. Dependent variables were fluence (mJ/mm 2 ), laser pulse repetition rate, and pressure applied between the device and the tissue. Results At 60 mJ/mm 2 , 40 Hz repetition rate and 1.4 kg/cm 2 pressure, all devices produced cutting rates in the range of 9–13 μm/pulse. Improvement in advancement per laser shot can be attained by increasing any independent variable studied. Conclusions Physicians must apply only slightly greater force to the larger laser sheaths, and maximum available repetition rate and fluence implies maximum cutting speed. Lasers Surg. Med. 22:42–45, 1998. © 1998 Wiley‐Liss, Inc.